College of Podiatry plans to develop database on potential skin-related symptoms in COVID - 19

There are presently a number of databases collecting data on suspected skin-related symptoms in COVID-19 infection across the world, and the College is actively communicating with colleagues abroad to gain a picture of what is available. It has recently had informal talks with colleagues in the United States of America on the potential for collaborative work, as well as in Australia and other Commonwealth countries. It is also exploring the possibility of using elements of the College’s own database, PASCOM 10, as a potential data collection tool for use by College members.  

As the number of reports on the issue of acral skin lesions potentially linked to COVID-19 increase, the College is also looking at ways to enhance the easy availability of access to dermatology resources for members, including the Dermnet NZ, a clinical dermatology website for healthcare professionals in New Zealand which has a page detailing and picturing some of the reported skin changes associated with COVID-19 infection. The site also has a wealth of accessible information on other dermatoses.

In line with the suspected skin-related symptoms associated with COVID-19, the College of Podiatry has sought and gained permission from The Primary Care Dermatology Society (PCDS) to utilise the Cunliffe (TP) Skin Lesion Diagnostic Table as a tool for members to refresh their differential diagnoses skills for cutaneous lesions. These flowcharts can be used to aid members in their assessments and clinical decision-making when presented with new acral lesions. For a visual guide and more detailed tables, please see the PCDS website.

The College of Podiatry continues to recommend the following guidance at present.  

1. As with all patient assessment and treatment during this period please follow the current College of Podiatry advice regarding clinical practice and use of PPE etc.

2. The likelihood of seeing these lesions at the present time in community and independent clinics is very small given the current reduced caseload.

3. If a patient presents with skin-related acral lesions but has no recognised COVID-19 symptoms (as indicated here) the current guidance is that self-solation is not recommended. Therefore, whilst there have been suggestions of a link between the skin-related acral lesions and COVID 19, they are not proven and there is no current recommendation that patients should self-isolate on the basis of the presence of skin lesions alone. Clinicians should use their clinical judgement and decision making on advising the patient. However, if others in the same household are symptomatic, then as per national guidance the patient should self-isolate accordingly. The College is continuing to collect evidence and data from various sources relating to this and other topics and will update this advice when required. 

4. If a patient has other symptoms consistent with Covid-19 which were not disclosed in your triage as per the decision tree they should be advised to contact 111.